SOUTHWEST ORAL & MAXILLOFACIAL SURGERY (NPI# 1457527368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457527368 |
Entity Type | Organization |
Organization Name | SOUTHWEST ORAL & MAXILLOFACIAL SURGERY |
Practice Address |
5900 Cubero Dr Ne Ste A Albuquerque NM 87109-3879 |
Practice Telephone | 5057973530 |
Practice Fax Number | 5057972155 |
Mailing Telephone | 5057973530 |
Mailing Fax Number | 5057972155 |
Enumeration Date | 2008-05-01 |
Last Update Date | 2011-12-06 |
Authorized Official Name | DR. JERRY L JONES (OWNER) |
Authorized Official Telephone | 5057973530 |
Authorized Official Credential | M.D.,D.D.S. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DD1094 | NM | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | E1446 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609006345 | Southwest Oral & Maxillofacial Surgery | Dentist | 916 Sw 38th St Ste A, Lawton, OK 73505-7005 | 2009-07-15 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Southwest Oral & Maxillofacial Surgery | 916 Sw 38th, Lawton, OK 73505 |
Street Address |
5900 CUBERO DR NE STE A |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87109-3879 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629615851 | Southwest Oral and Maxillofacial Surgeons LLC | Clinic/Center | 5900 Cubero Dr Ne Ste A, Albuquerque, NM 87109-3879 | 2019-12-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
Find all providers in zip 87109 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629460951 | Mark Conover | Dentist | 7050 Barstow St Ne, Albuquerque, NM 87111-1056 | 2015-02-24 |
1265671770 | Sandia Oral Surgery and Dental Implant Center | Dentist | 7009 Montgomery Blvd. Ne, Albuquerque, NM 87109 | 2009-02-08 |
1598929242 | West Mesa Oral and Maxillofacial Surgery PC | Dentist | 4801 Mcmahon Blvd Nw Ste 230, Albuquerque, NM 87114-5478 | 2008-07-11 |
1013179530 | Joyce Ann Jeffries | Dentist | 9674 Eagle Ranch Rd Nw, Suite 1, Albuquerque, NM 87114-1580 | 2008-06-26 |
1447324280 | David Eric Tuggle | Dentist | 7009 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2006-11-20 |
1275613788 | Timothy L Gutierrez Sr. | Dentist | 1513 Carlisle Blvd Ne, Albuquerque, NM 87110 | 2006-10-17 |
1104930288 | Jeffery Bryan Wheaton | Dentist | 1628 Alameda Blvd Nw, Albuquerque, NM 87114 | 2006-08-18 |
1063470904 | James D Crine II | Dentist | 4550 Eubank Ne Ste #103, Albuquerque, NM 87111 | 2006-05-02 |
1750359618 | Lionel Michael Candelaria | Dentist | 6800 Montgomery Blvd Ne Ste A, Albuquerque, NM 87109-1425 | 2006-03-08 |
1346217775 | John Compton Mitchell | Dentist | 6800 Montgomery Blvd Ne, Suite A, Albuquerque, NM 87109-1405 | 2006-03-03 |
Find all providers in ALBUQUERQUE |
City | ALBUQUERQUE |
Zip Code | 87109 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.